Diagnosing slipped capital femoral epiphysis amongst various medical specialists

被引：2

作者：

Lam, A. ^{[1
]}

Boenerjous, S. A. ^{[2
]}

Lo, Y. ^{[3
]}

Abzug, J. M. ^{[4
]}

Kurian, J. ^{[5
]}

Liszewski, M. C. ^{[5
]}

Sanderson, D. E. ^{[6
]}

Scholnick, J. M. ^{[6
]}

Taragin, B. H. ^{[5
]}

Gomez, J. A. ^{[7
]}

Otsuka, N. Y. ^{[7
]}

Hanstein, R. ^{[7
]}

机构：

[1] Albert Einstein Coll Med, Bronx, NY 10467 USA

[2] Montefiore Med Ctr, Dept Orthopaed Surg, 111 E 210th St, Bronx, NY 10467 USA

[3] Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, New York, NY USA

[4] Univ Maryland, Sch Med, Baltimore, MD 21201 USA

[5] Montefiore Med Ctr, Dept Radiol, Paediat Radiol, New York, NY USA

[6] Montefiore Med Ctr, Dept Paediat, Gen Paediat, New York, NY USA

[7] Montefiore Med Ctr, Childrens Hosp, Div Paediat Orthopaed, New York, NY USA

来源：

JOURNAL OF CHILDRENS ORTHOPAEDICS | 2018年 / 12卷 / 02期

关键词：

Slipped capital femoral epiphysis; paediatric; radiographic diagnosis; medical specialists; TERM FOLLOW-UP; DELAY; AGREEMENT; SEVERITY; PAIN;

D O I：

10.1302/1863-2548.12.170200

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Purpose To evaluate sensitivity, specificity and accuracy of a radiographic slipped capital femoral epiphysis (SCFE)-diagnosis among medical specialists. Methods Three paediatricians, three paediatric radiologists and three paediatric orthopaedic surgeons completed two rounds of a survey of anteroposterior and frog-leg lateral radiographs of patients with a diagnosis of SCFE (25), femoroacetabular impingement (four), Legg-Calve-Perthes (11) or no hip pathology (ten). Intra-and interobserver agreement among specialties regarding the diagnosis of a SCFE were assessed using Cohen's kappa coefficient (kappa). Diagnostic accuracy of SCFE relative to the benchmark, a combination of the radiographic diagnosis based on Klein's line, clinical symptoms and surgical treatment, was assessed computing sensitivity, specificity and accuracy. Results Intraobserver agreement between the surveys was moderate among paediatricians (kappa-range, 0.44 to 0.52), moderate to almost perfect among orthopaedic surgeons (kappa-range, 0.79 to 0.88) and almost perfect among paediatric radiologists (kappa-range, 0.83 to 1.00). Interobserver agreement for survey 1 and 2 was slight among paediatricians (mean kappa, 0.19), substantial among orthopaedic surgeons (mean kappa, 0.77) and almost perfect among paediatric radiologists (mean kappa, 0.86). Sensitivity of SCFE-diagnosis was high among radiologists and orthopaedic surgeons (88% to 100% for both specialties), but lower for paediatricians (24% to 76%). Specificity was high among radiologists and orthopaedic surgeons (72% to 84%), however, variable among paediatricians (56% to 80%). Accuracy of a SCFE-diagnosis was highest in radiologists (84% to 92%), followed by orthopaedic surgeons (80% to 88%) and paediatricians (48% to 78%). Conclusion SCFE can be detected on radiographs by different medical specialties. Intra-and interobserver agreement, specificity, sensitivity and accuracy for radiographic SCFE-diagnosis amongst paediatric radiologists and orthopaedic surgeons are better than that of general paediatricians.

引用

页码：160 / 166

页数：7

共 35 条

[1] Delay in diagnosis of slipped upper femoral epiphysis [J].